In anatomy, zenkers diverticulum, also pharyngoesophageal diverticulum, also pharyngeal pouch, is a diverticulum of the mucosa of the pharynx, just above the cricopharyngeal muscle i. It has a thick wall with strong muscles that push food down to. Zenkers diverticulum is an outpouching of the esophagus which may occur due to increased pressure caused by muscle spasms forcing the mucous membrane through a defect in the esophageal wall. Pdf nursing approach to zenkers diverticulum surgery. It causes swallowing difficulties dysphagia, regurgitation, weight loss, and other symptoms. Breakthrough in endoscopic treatment of zenkers diverticulum. An esophageal diverticulum is an outpouching that develops in a weakened area of the esophagus. These diverticula are uncommon and tend to occur in elderly people.
Zenkers diverticulum surgery endoscopic staple diverticulostomy. To consider how zenker diverticulum arises, its important you understand the swallowing process. When an otolaryngologist performs open surgical excision of a zenkers diverticulum, he or she should report cpt code. Zenkers diverticulum smelly breath ruining your day duration. This procedure is done under a general anesthesia at the hospital.
On june, 2016 june 8, 2016 by giejournal in investigations 1 comment. Zenkers degeneration medical definition merriamwebster. Zenkers diverticulum is a rare disease, which can cause considerable suffering. The most common type of outpouching in the esophagus, due to increased pressure causing the mucous membrane of the esophagus to herniate through a defect in the wall of esophagus. When measured using acoustic anlaysis software, it has been demon. Common symptoms of the disease include difficulties in swallowing dysphagia, food reflux regurgitation, unpleasant breath smells halitosis and couch. Dysphagia that is the result of persistent cricopharyngeal spasm andor a zenkers diverticulum is particularly amenable to surgical correction. A zenkers diverticulum, also pharyngeal pouch, is a diverticulum of the mucosa of the human pharynx, just above the cricopharyngeal muscle it is a pseudo. In simple words, when there is excessive pressure within the lower pharynx, the weakest portion of the pharyngeal wall balloons out, forming a diverticulum which may reach several centimetres in diameter more precisely, while traction and pulsion mechanisms have long been deemed the main factors promoting development of a zenkers diverticulum, current consensus considers.
Zenkers diverticulum is a rare, benign throat disorder seen mainly in elderly people. Zengers diverticulum is false diverticulum consisted of. An outpouching of the pharyngeal mucosa and submucosa through the cricopharyngeus muscle. The following are the presented options for the medical condition. The kidneys, originally diverticula in the development of the urinary and reproductive organs the lungs, originally diverticula forming off of the ventral foregut the thymus appears in the form of two flaskshape diverticula, which arise from the third branchial pouch pharyngeal pouch of the endoderm the thyroid gland develops as a diverticulum arising from a point on. Source for the table information obtained from endoscopic staple diverticulostomy for zenkers diverticulum. The most common form, zenkers diverticulum is found at the level of the lower neck and usually at the back of the throat. Zenkers diverticulum location, symptoms, treatment. Zenkers diverticulum is a esophageal pouch that protrudes outward in a weak portion of the esophageal lining. A patients barium swallow study for a zenkers diverticulum. This is known in the 70s as the first surgical intervention for zenkers diverticulum.
Zenkers diverticulum and other esophageal diverticula. Baron, in clinical gastrointestinal endoscopy third edition, 2019. This product line is serviced by the following clinical divisions. Zenkers diverticulum ent services in arizona valley ent. Zenkers diverticulum zd, also known as cricopharyngeal, pharyngoesophageal or hypopharyngeal diverticulum, is a rare condition characterized by an acquired outpouching of the mucosal and. Zenkers diverticulum is a condition characterized by a pouch that can form at the junction of the hypopharynx lower part of the throat and the esophagus. Zenker diverticulum location anatomy of the esophagus.
If that was unsuccessful he would go to plan b which involved an incision in my lower neck region. Animate model esophageal poem and zpoem, possibly gpoem. It is generally seen among people above the age of 60, and it is thought that this situation occurs as a result of the loss of tissue elasticity and decreased muscle tonus. Although zenkers diverticulum is the most common type of esophageal diverticulum, the true incidence is difficult to determine because so many people with the disorder. Large zenker diverticula with the septum longer than 6 cm should preferably.
Asge has the right to cancel a program at any time at its discretion. May occur with dysphasia or foulsmelling breath in old people. It is a rare disease typically seen in the middleaged and older adults. Pathology demonstrated a 10 x 7 x 4cm diverticulum with two date nucleus in the diverticulum figure 4. Some neurologic diseases, such as a stroke, may result in malfunctioning of the cricopharyngeal muscle. Zenkers diverticulum zd is an outpouching of tissue through killians triangle thought to be due to cricopharyngeal muscle dysfunction. Zenker diverticulum, also known as a pharyngeal pouch, is a posterior outpouching of the hypopharynx, just proximal to the upper esophageal sphincter through a weakness in the muscle layer called the killian dehiscence. Dysphagia foundation, theory and practice inclusion body. Endoscopic stapleassisted diverticulostomy in the treatment zenkers diverticulum zd is an acquired pulsion pouch that was first described by ludlow in 1769. It is commonly seen in elderly patients at the back of the lower throat. Under direct visualization, the common wall between the pouch and the esophagus is ablated usually with the carbon. Classified as false diverticulum in that it does not contain all layers of the intestinal wall, but only the mucosa and submucosa.
Review of literature and experience in 159 consecutive cases. This relatively uncommon disorder, which occurs more commonly in the elderly, presents with symptoms of dysphagia. A pharyngeal pouch also known as a zenkers diverticula is an outpouching of pharyngeal. Zenker diverticulum zd is an uncommon pharyngoesophageal outpouching that occurs in an area of muscular weakness at the junction of the inferior aspect of the inferior constrictor muscle and the cricophayngeus muscle killian dehiscence.
Pharyngoesophageal diverticulum zenkers diverticulum is the most frequent diverticulum of the esophagus. Zenker diverticulum, a pulsion diverticulum of the hypopharynx, is a rare lesion that occurs in elderly populations. Gif anime, animated gif, animation, looks cool, mind blown, human body. The esophagus is a long hollow tube that runs from the pharynx throat to the stomach. Zenkers diverticulum zd is an acquired sac originating from.
A septum between the diverticulum and the lumen of the esophagus can develop and hamper the passage of food. We aim to become the reddit home of radiologists, radiographers, technologists, sonographers and layusers interested in medical imaging. The diverticulum is exposed with a bivalved twoblade endoscope with one blade in the pouch and the other blade in the cervical esophagus. This pear shaped structure appears mainly in the neck between the constritors and cricopharyngeal muscles. A 62yearold male with zenkers diverticulum zd underwent endoscopic diverticulectomy for dysphagia and weight continue reading endoscopic treatment of zenkers diverticulum. Zenker diverticulum definition of zenker diverticulum by. Zenkers diverticulum southern california, orange county. Zenker diverticulum is the most common form of esophageal diverticulum, according to the national institutes of health, with a 0. Zd is actually a pseudodiverticulum since the zenkers pouch contains only esophageal mucosa and submucosa.
Barium swallow of a patient with midthoracic or traction diverticulum. Natural treatment zenkers diverticulum home healthy. Anatomically there is a loose bulge of the dorsal wall of the hypopharynx. Asgejges masters course in poem and third space endoscopy. The surgery is designed to release the tightened cricopharyngeal muscle, often in conjunction with removal of the zenkers diverticulum sac.
This pouch typically causes problems by trapping food as it is being swallowed, leading to dysphagia difficulty swallowing, regurgitation of. Baron also discusses traditional surgical management, as well as. Lateral during swallowing an outpouching of the posterior hypopharyngeal wall is clearly visualized at the level c5c6, right above the upper esophageal sphincter. This condition also receives the name of zenkers diverticulum 2, a german. Zenkers diverticulum medical definition merriamwebster. Malfunctioning of the cricopharyngeal muscle with aging seems to be the main cause.
Zenkers diverticulum barium swallow youtube barium swallow, visual aids. A zenkers diverticulum is an esophageal pouch that develops in the upper esophagus which causes difficulty swallowing and regurgitation of food. There are a number of surgical interventions for zenkers diverticulum. With the patient in the supine position on the operating table and after adequate general endotracheal anesthesia had been obtained, the face was draped with sterile drapes. Zenkers diverticulum university of missouri system. Patients with this condition often exhibit no symptoms. Comparing different surgical approaches for zenkers. A zenkers diverticulum is an outpouching that occurs at the junction of the lower part of the throat and the upper portion of the esophagus. A proven program to prevent and reverse the new silent epidemic.
It is an outpouching that develops in a weakened area at the back of the throat. Zenker diverticulum liver pancreas foregut surgery. Therefore, a barium swallow and meal was performed which confirmed the large zenkers diverticulum with compression of the adjacent. Report a case of huge zenkers diverticulum with date. The condition goes by several names, depending on the location of the pouch.
Zenker diverticuli are usually located in the posterior hypopharyngeal wall. A diverticulum is a pouch that appears on the wall of a viscous. Zenkers diverticula are usually located in the back of the throat, just above the esophagus why zenkers diverticulum must be removed. The pouch is characterized by a narrow neck entrapping some barium after the. Small zenker diverticuli may not cause symptoms but larger ones may collect food and obstruct the. The zenkers diverticulum overtube is intended to act as a diverticuloscope for the purpose of creating a diverticulotomy in patients with zenkers diverticulum. It is acquired, and not a real but a pulsion diverticulum. Zenkers diverticulum cricopharyngeal muscle myotomy diverticulectomy endoscopic stapling. Todd baron defines zenkers diverticulum and its symptoms. Vistudent of the graduate program in general surgery, medical school of. A straight scope is used to evacuate any material in the pocket and make sure the pocket is large enough to divide the common wall between it and the esophagus, or swallowing tube. Man swallowing barium during an xray stock photos, home exercise program. Zenkers diverticulum is a pouch found above the cervical esophagus.
Umar handdrawn videos zenkers diverticulum please visit my website facebook page. Zenkers diverticulum is a pouch protruding posteriorly above the upper esophageal sphincter, in the killians triangle, an area of relative weakness. It develops within a natural anatomic dehiscence zone killians triangle, which is located between the cricopharyngeal and the inferior constrictor muscles, and is due to failure of the. Hypo pharynx diverticulitis can be true, when include all layers of the wall, and false which does not usually include muscular layer. Diagnostic testing o laboratory evaluation little or no value o diagnostic imaging barium swallow study of choice posterior midline pouch 2 cm diameter arising just above cricopharyngeus muscle. Zenkers diverticulum is a pouch at the back of the throat at a weak spot where the throat and esophagus join. Zenkers diverticulum zd is a condition characterized by a pouch that develops in the upper esophagus in the neck.
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